On average, people can write approximately 30 words a minute, type 45 words a minute and speak 150 words a minute. So, for most of us, we speak five times faster than we can handwrite and three times faster than we can type. And the faster we handwrite, the less legible our handwriting tends to be.
If a physician spends one minute dictating a patient’s record, it follows that it would take them approximately five minutes to write it out by hand. The challenge to the physician is three-fold – how much time do they spend documenting the patient visit, how detailed are the patient notes, and how legible are the patient notes?
Dictating patient records addresses all three of these issues – less time is spent documenting the patient visit (as we speak faster than we write), more detail can be included as more information can be conveyed in the available time, and transcribed notes are perfectly legible. For physicians who already type their patient records or reports, the first two benefits may still apply.
For example, a family physician who sees 30 patients a day, may spend 20 minutes dictating their patient notes in SOAP format at the end of the day. If they were to spend even twice, or up to five times, as long handwriting their notes instead of dictating, they would have at least 20 minutes less each day to see patients (or would work at least 20 minutes more).
If each patient note is 6 – 8 lines, then having the notes transcribed would cost $30 – $40 per day. Under 2010 OHIP Fee Schedule for Family Practice and Practice in General (00), General Listings, this cost is substantially less than the family physician’s capacity to bill OHIP for an additional consultation(s)/limited consultation(s) during the time saved by dictating the patient notes, instead of handwriting them.
The physician has a net increase in income (increased number of patients seen and billed less the cost of having patient records transcribed), as well as the added advantage of excellent legibility and even perhaps the benefit of having more detailed patient records.
To see what the effect would be for your practice, consider tracking your time for a day or even a week. Note how many minutes you spend documenting your patient record on each visit. Or even sample the time you spend over the course of a part of a day. Ask a colleague or staff member to read some of your handwritten documentation. Does your colleague have to stop and ask you what a particular abbreviation means? Or hesitate over certain words?
Consider doing a self-audit (as suggested by the CPSO) on your patient records, found at http://www.cpso.on.ca/policies/policies/default.aspx?ID=1686.
If the time to document a patient encounter is greater than two minutes, if more detail would be dictated than handwritten, or if the legibility of the patient notes is questionable, then consider dictating your patient notes and having them transcribed.
2Ascribe Inc. is a medical transcription services agency located in Toronto, Ontario Canada, providing medical transcription services to physicians, clinics and other healthcare providers across Canada. With WEBscribe, a client interface portal for document management, 2Ascribe continues to implement and develop technology to assist and improve the transcription process for physicians and other healthcare providers. As a service to our clients and the healthcare industry, 2Ascribe offers articles of interest to physicians and other healthcare professionals, medical transcriptionists and office staff, as well as of general interest. Additional articles may be found at http://www.2ascribe.com/category/articles/dictation-tips and http://www.2ascribe.com/category/articles.
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